Infant with dyspareunia Clinical presentation: Infant (<6 months) has prolonged straining to defecate for more than a few minutes, screaming and crying, with a distended red or purple face caused by the effort. It may last for 10-20 minutes until soft or loose stool is passed. There may be several bowel movements per day. Symptoms can appear in the first month of life and may resolve on their own after a few weeks. Difficult defecation in infants Diagnostic criteria: The following conditions must be met (<6 months): Difficult defecation in infants Clinical evaluation: Medical history (including diet), physical examination (including rectal examination) exclude anorectal pathology and growth and development are normal. Cause: The infant failed to coordinate the relaxation of the pelvic floor muscles during defecation when the abdominal pressure increased, and crying increased the intra-abdominal pressure. Once the infant was able to coordinate the relaxation of the pelvic floor muscles during defecation, the symptoms disappeared. Manipulation of the rectum to aid defecation is not advocated because it may affect the rectal sensory function of the child or may create a sensation of waiting for a stimulus before defecation. Laxatives are also not required.